Factors Affecting Quality of Sleep in Intensive Care Unit

Background: The etiology of sleep disruption in intensive care unit is poorly known and often ignored complication. It is caused by the environmental factors especially pain, noise, diagnostic testing and human interventions that cause sleep disruption. Light, medications and activities related to patient care interfere with patient's ability to have good sleep. There are multi-factorial environmental etiologies for disruption of sleep in ICU. Objective: The objective of this study was to evaluate the factors disturbing the sleep quality in intensive care unit (ICU) admitted patients. Methodology: A cross sectional study was designed involving 150 patients admitted in intensive care unit and high dependency unit of Gulab Devi Chest Hospital. The duration of study was from September 2015 to March 2016. The questionnaire was made and filled with the help of patients. The data was analyzed using SPSS version 16.00. Results: Mean age of patients was 50.46+10.96 with maximum age of 65 and minimum age of 30 years. There was 53.33% male patients and 46.67% females participating in this study. The sleep quality was significantly poor in ICU than at home. After analysis, 54.67% patients were with poor quality of sleep due to pain and 48.67% were due to noise of environmental stimuli. The other factors were alarms, light and loud talking. Conclusion: Current study shows that reduced sleep quality is a common problem in ICU with multi-factorial etiologies. Patient reported the poor sleep quality in ICU due to environmental issues that are potentially modifiable. Conclusion: Current study shows that reduced sleep quality is a common problem in ICU with multi-factorial etiologies. Patient reported the poor sleep quality in ICU due to environmental issues that are potentially modifiable

History Dependent Quantum Random Walks as Quantum Lattice Gas Automata

Quantum Random Walks (QRW) were first defined as one-particle sectors of Quantum Lattice Gas Automata (QLGA). Recently, they have been generalized to include history dependence, either on previous coin (internal, i.e., spin or velocity) states or on previous position states. These models have the goal of studying the transition to classicality, or more generally, changes in the performance of quantum walks in algorithmic applications. We show that several history dependent QRW can be identified as one-particle sectors of QLGA. This provides a unifying conceptual framework for these models in which the extra degrees of freedom required to store the history information arise naturally as geometrical degrees of freedom on the lattice.Comment: 18 pages, 3 figure

Intracranial Hemorrhage Due to Secondary Hypertension from Intracranial Large Vessel Occlusion

Simultaneous hemorrhagic and ischemic strokes have been previously reported in the literature. Typically, these occur in patients secondary to dialysis, cerebral amyloid angiopathy, or thrombotic thrombocytopenic purpura.1,2,3 However, this is the unique case of a 62-year-old Asian female who presented with a hemorrhagic stroke suspected to be secondary to refractory hypertension from intracranial large vessel atherosclerotic flow limiting stenosis, with rapid subsequent large vessel occlusion and ischemic stroke. Questions arise such as ideal blood pressure parameters for dual management, timeliness of computed tomography angiography imaging in the emergency department for detection of large vessel occlusion during intracranial hemorrhage, and subsequent selection of treatment plan in the dual-lesion patient population

High-entropy ejections from magnetized proto-neutron star winds: implications for heavy element nucleosynthesis

Although initially thought to be promising for production of the r-process nuclei, standard models of neutrino-heated winds from proto-neutron stars (PNSs) do not reach the requisite neutron-to-seed ratio for production of the lanthanides and actinides. However, the abundance distribution created by the r-, rp-, or $\nu p$-processes in PNS winds depends sensitively on the entropy and dynamical expansion timescale of the flow, which may be strongly affected by high magnetic fields. Here, we present results from magnetohydrodynamic simulations of non-rotating neutrino-heated PNS winds with strong dipole magnetic fields from $10^{14}-10^{16}$ G, and assess their role in altering the conditions for nucleosynthesis. The strong field forms a closed zone and helmet streamer configuration at the equator, with episodic dynamical mass ejections in toroidal plasmoids. We find dramatically enhanced entropy in these regions and conditions favorable for third-peak r-process nucleosynthesis if the wind is neutron-rich. If instead the wind is proton-rich, the conditions will affect the abundances from the $\nu p$-process. We quantify the distribution of ejected matter in entropy and dynamical expansion timescale, and the critical magnetic field strength required to affect the entropy. For $B\gtrsim10^{15}$ G, we find that $\gtrsim10^{-6}$ M$_{\odot}$ and up to $\sim10^{-5}$ M$_{\odot}$ of high entropy material is ejected per highly-magnetized neutron star birth in the wind phase, providing a mechanism for prompt heavy element enrichment of the universe. Former binary companions identified within (magnetar-hosting) supernova remnants, the remnants themselves, and runaway stars may exhibit overabundances. We provide a comparison with a semi-analytic model of plasmoid eruption and discuss implications and extensions.Comment: accepted to MNRA

R-PEKS: RBAC Enabled PEKS for Secure Access of Cloud Data

In the recent past, few works have been done by combining attribute-based access control with multi-user PEKS, i.e., public key encryption with keyword search. Such attribute enabled searchable encryption is most suitable for applications where the changing of privileges is done once in a while. However, to date, no efficient and secure scheme is available in the literature that is suitable for these applications where changing privileges are done frequently. In this paper our contributions are twofold. Firstly, we propose a new PEKS scheme for string search, which, unlike the previous constructions, is free from bi-linear mapping and is efficient by 97% compared to PEKS for string search proposed by Ray et.al in TrustCom 2017. Secondly, we introduce role based access control (RBAC) to multi-user PEKS, where an arbitrary group of users can search and access the encrypted files depending upon roles. We termed this integrated scheme as R-PEKS. The efficiency of R-PEKS over the PEKS scheme is up to 90%. We provide formal security proofs for the different components of R-PEKS and validate these schemes using a commercial dataset

The Effect of Magnetic Field Tilt and Divergence on the Mass Flux and Flow Speed in a Line-Driven Stellar Wind

We carry out an extended analytic study of how the tilt and faster-than-radial expansion from a magnetic field affect the mass flux and flow speed of a line-driven stellar wind. A key motivation is to reconcile results of numerical MHD simulations with previous analyses that had predicted non-spherical expansion would lead to a strong speed enhancement. By including finite-disk correction effects, a dynamically more consistent form for the non-spherical expansion, and a moderate value of the line-driving power index $\alpha$, we infer more modest speed enhancements that are in good quantitative agreement with MHD simulations, and also are more consistent with observational results. Our analysis also explains simulation results that show the latitudinal variation of the surface mass flux scales with the square of the cosine of the local tilt angle between the magnetic field and the radial direction. Finally, we present a perturbation analysis of the effects of a finite gas pressure on the wind mass loss rate and flow speed in both spherical and magnetic wind models, showing that these scale with the ratio of the sound speed to surface escape speed, $a/v_{esc}$, and are typically 10-20% compared to an idealized, zero-gas-pressure model.Comment: Accepted for publication in ApJ, for the full version of the paper go to: http://www.bartol.udel.edu/~owocki/preprints/btiltdiv-mdotvinf.pd